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. 2008 Jul;105(28-29):501-6.
doi: 10.3238/arztebl.2008.0501. Epub 2008 Jul 14.

Trend reversal in the frequency of mycoses in hematological neoplasias: autopsy results from 1976 to 2005

Konrad Donhuijsen  1 , Peter Petersen, Werner Kurt Schmid
Affiliations

Trend reversal in the frequency of mycoses in hematological neoplasias: autopsy results from 1976 to 2005

Konrad Donhuijsen et al. Dtsch Arztebl Int. 2008 Jul.

Abstract

Introduction: Fungal infections of internal organs are a major complication for patients with hematological neoplasias. For more than 20 years, the frequency of such mycoses has been increasing with the aggressiveness of tumor treatment.

Methods: Autopsy findings over a 30-year period (1976 to 2005) from a single institution (Institute of Pathology, University of Essen) were retrospectively classified according to basic disease, frequency of mycoses, kind of mycoses, organs involved, hematopoietic transplantation, and cause of death.

Results: 340 of 1591 autopsied patients with hematological neoplasias (21.4%) revealed an invasive mycosis. The proportion increased from about 10% before 1980 to some 30% in the 1990s but fell to 21% by 2005. The frequency of mycoses decreased significantly both for transplanted patients (from 47.5% to 30.3%) and for non-transplanted patients (from 29.8% to 16.4%). The rate of deaths due to mycosis also decreased. The relative frequency of candidal mycoses went down, while aspergilloses predominated. The organ most frequently involved was the lung.

Discussion: The autopsy results signal a trend reversal in the leading complication of the treatment of hematological neoplasias and lend support to the assumption that antimycotic strategies are having a positive effect.

Keywords: autopsy; hematological neoplasia; leukemia; lymphoma; mycosis.

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Figures

Figure 1
Figure 1
Five-year frequency of invasive mycoses in hematological neoplasias. Significant group differences and 95% confidence intervals (mean 21.4%; 340 of 1591 patients).
Figure 2
Figure 2
Frequency of deep mycoses in different neoplasias. Changes with time
Figure 3
Figure 3
Five-year mycosis rate after hematological transplantations. Significant group differences and 95% confidence intervals (mean 36%; 96 of 267 patients).
Figure 4
Figure 4
Mycosis rate in non-transplanted patients with hematological neoplasias. Significant group differences and 95% confidence intervals (mean 18.4%; 244 of 1324 patients).
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References

    1. Viscoli C, Girmenia C, Marinus A, et al. The Invasive Fungal Infection Group of the EORTC. Candidemia in cancer patients. A prospective, multicenter surveillance study in Europe by the the Invasive Fungal Infection Group (IFIG) of the European Organization für Research and Treatment of Cancer (EORTC) Clin Infect Dis. 1999;28:1071–1079. - PubMed
    1. Ruhnke M, Boehme A, Buchheidt D, et al. Diagnosis of invasive fungal infections in hematology- and oncology-guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO) Ann Hematol. 2003;82:141–148. - PubMed
    1. Herbrecht R, Denning DW, Petterson TF, et al. Voriconazole versus Amphotericin B for primary therapy of invasive aspergillosis. N Engl J Med. 2002;347:408–415. - PubMed
    1. Mora-Duarte J, Betts R, Rotstein C, et al. Comparison of Caspofungin and Amphotericin B for invasive candidiasis. N Engl J Med. 2002;347:2020–2029. - PubMed
    1. De Pauw BE, Donnelly JP. Prophylaxis and aspergillosis - has the principle been proven? N Engl J Med. 2007;356:409–411. - PubMed